Most young adults attempting weight loss regained weight at 3 years

December 06, 2021

3 min read

Hayes reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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More than half of young adults participating in a weight-loss intervention had a weight gain above baseline at 3 years, according to study data published in Obesity.

In findings from the Study of Novel Approaches to Weight Gain Prevention (SNAP) trial, 52% of trial participants had a body weight above baseline at 3 years of follow-up, and infrequent self-weighing and low dietary restraint were significantly associated with a transition to weight above baseline.

“Intervening while weight gains are smaller and recommending [more] weight-loss strategies may be clinically beneficial.” Jacqueline F. Hayes, PhD

“If participants started to put on weight, it was a struggle to lose,” Jacqueline F. Hayes, PhD, a postdoctoral research fellow at The Miriam Hospital in Providence, Rhode Island, and the Warren Alpert Medical School of Brown University, told Healio. “This has been shown in prior studies following weight-loss interventions, but our study indicates this may be problematic in the context of weight-gain prevention interventions as well. Additional findings showed those who gained less weight and used more weight-loss strategies were more successful in recovering from weight gains.”

Hayes and colleagues conducted a secondary analysis of data from SNAP, a three-arm randomized controlled trial in which 599 adults aged 18 to 35 years were randomly assigned to a large-change intervention designed to create a 5 lb to 10 lb buffer against weight gain over time, a small-change intervention in which participants made small consistent dietary and physical activity changes to prevent weight gain, or a control group. The two intervention groups attended a 4-month in-person group program, whereas the control group performed self-directed self-regulation with no further intervention contact. Weight and height were collected at baseline, 4 months, 1 year, 2 years and 3 years. Participants reported their frequency of self-weighing, level of dietary restraint, diet, physical activity and number of weight-management strategies used at each follow-up.

Weight gain common at 3 years

The proportion of participants above their baseline weight increased from 24% at 4 months to 52% at 3 years. From one time point to the next, about twice the number of participants transitioned from below baseline weight to above compared with the number of adults transitioning from above to below baseline.

“One surprising finding was the number of participants who gained weight and were unable to lose it,” Hayes said. “At each time point that we measured, only half the amount of people who gained weight above their starting weight lost it. By 3 years, over 50% of participants were above their starting weight. This points to the challenges young adults may face in maintaining their weight over time, even with intervention.”

Compared with the control group, fewer participants were above baseline weight at all time points in the large-change intervention, and at 4 months and 2 years in the small-change intervention. Compared with the small-change group, fewer participants in the large-change group were above baseline weight at 4 months and 1 year.

Fewer weight-loss strategies linked to weight gain

Participants who transitioned from above to below baseline weight used a mean 5.55 weight-loss strategies at 12 months compared with a mean 3.85 weight-loss strategies used by people who remained above baseline. Participants who transitioned from below to above baseline used a mean 3.64 weight-loss strategies at 12 months compared with 6.46 mean weight-loss strategies used for people who remained below baseline weight. The differences in weight-loss strategies used were similar at 24 months.

Participants who performed less self-weighing and less dietary restraint were more likely to gain weight above baseline at 12 and 24 months than those who remained below baseline. Disinhibition, calorie consumption and physical activity level did not predict weight transitions.

“The findings point to the importance of providing additional support for participants in weight-gain prevention programs following intensive intervention, since most people were not able to lose weight they had gained on their own,” Hayes said. “Based on what we observed, intervening while weight gains are smaller and recommending the use of a greater number of weight-loss strategies may be clinically beneficial.”

For more information:

Jacqueline F. Hayes, PhD, can be reached at

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